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General NPI Number Information
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NPI Number | 1316476823
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Entity Type | Individual
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Provider Name | SAMUEL N PRICE DO
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Gender | Male
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 206 W TYSON ST STE 1A
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City | VERSAILLES
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State | IN
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Zip | 47042-8036
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Country | US
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Telephone | 812-689-5101
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Fax | 812-689-6199
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 125070950
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 02005959A
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License Number State | IN
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